| Previous Section | Index | Home Page |
9.30 pm
Mr. Stephen O'Brien (Eddisbury) (Con): I welcome the new Minister of State, the hon. Member for Leigh (Andy Burnham), and the new Under-Secretary, the hon. Member for Bury, South (Mr. Lewis) to their posts. I also welcome the promotion of the former Under-Secretary of State, the hon. Member for Don Valley (Caroline Flint) to Minister of State.
We are here to hold the Secretary of State to account for the shambolic way in which she has mismanaged the finances of our national health service. She somehow avoided the Prime Minister’s Cabinet purge last week. More than anything else, the Prime Minister’s fatigue with the NHS is shown by the fact that he is happy for it to limp on under her misdirection. With the continued incompetent leadership of the Department of Health, it is timely that we should provide the Government with the chance to bring in a turnaround team.
In this debate, we have heard countless examples of the impact of that incompetence on constituents of Members on both sides of the House, and of the cuts in front-line patient services as a result of those financial pressures. We heard first from the Chairman of the Health Committee, the right hon. Member for Rother Valley (Mr. Barron), and methinks he doth protest a bit too much. Having given the Secretary of State a lesson in how to deploy statistics, he should reflect on the way in which his speech was analysed by the former Secretary of State for Health, my right hon. Friend the Member for Charnwood (Mr. Dorrell), who spoke immediately afterwards. He described accurately how and why many members of the national health service reacted to the Secretary of State as they did. He showed that the constant reorganisation and the way in which things have gone full circle have caused a serious
collapse in morale, and that frustration and anger have been caused by the constant management changes from the centre, leading to mismanagement of resources. That illustrated the real difference between the approach taken by the governing party and the alternative.
We also heard the hon. Member for Wyre Forest (Dr. Taylor), who is in his place, talk from experience about the fear that underlies the quality of care issues. Apart from advocating the return of matrons, which is close to the Opposition’s heart, he told us how reforms needed to be put on hold for a moment.
We heard an interesting contribution from the hon. Member for Dartford (Dr. Stoate), a practising doctor, who described the increase in pay for doctors as of some interest. I do not think that he is in his place at the moment. He was followed by the hon. Member for High Peak (Tom Levitt), whose many interventions must have lasted as long as his speech. He made only one point that I thought was worth putting on record—about the difficulty of being on the border between two English regions and the disparities that that creates. I ask him to consider the problems of being on the border with Wales. The health provision for my constituents in Farndon is completely different from that for those in Holt in Wales, 200 yd across the River Dee. Those disparities are caused by the ill-thought-through devolution of health in Wales.
One of the most interesting experiences in a long debate was the speech by the hon. Member for Mitcham and Morden (Siobhain McDonagh), who, after relating some personal stories, delivered one of the longest ranting press releases that any of us has had to hear. On the question of health inequalities, she made the serious point that the Secretary of State was advised by the director of public health in London, Dr. Sue Atkinson, who, I am told, said that the Secretary of State’s decision was precisely the wrong one to address the health inequalities in her area. No wonder the hon. Lady did not like the professional health establishment. Not surprisingly, none of its members agreed with her, or, indeed, with the Secretary of State.
We then heard rather a long speech by the hon. Member for Colne Valley (Kali Mountford). We also heard some interesting definitions of markets from the hon. Member for Southport (John Pugh). I think we were all genuinely moved by the personal testimony of the hon. Member for Keighley (Mrs. Cryer), which was much appreciated.
It may have gone unnoticed by many Members that, having described her own experiences, the hon. Member for North-East Derbyshire (Natascha Engel) referred emphatically to the patients forums. She hoped that they would continue doing work that she thought would be useful. In fact, it has been announced that they will be scrapped. After much argument—not least an argument in which I was personally involved—the Government replaced the community health councils, which were scrapped. Yet again there had been a false claim by the Prime Minister, for which he had to apologise to me in a three-page letter, that he had consulted before he decided to axe them.
However, the hon. Lady also made an important point with which I think all Members would agree—that we should send our good wishes to the Doorkeeper Calvin Thomas. Some of us were around
when he collapsed, and I think the whole House will welcome the news that he has undergone a successful operation.
The hon. Member for Kingston upon Hull, North (Ms Johnson) was, of course, perfectly entitled to say that the NHS was a political issue, but she implied that if people did not agree with her about the way in which it was funded, they were clearly not in favour of the service itself. All Members throughout the House agree that it should be a national health service, free at the point of need and supported by central taxation, with equity of access.
At the time of the most recent general election, there was a clear commitment from the official Opposition to expenditure equal to the amount proposed by the Government and announced by the Chancellor for the period up to 2008, however the money was to be raised. The Government have not committed themselves to any amount beyond 2008. The suggestion being made in the Whips’ handouts to the parliamentary Labour party is therefore a complete Aunt Sally. I have some of the notes here. The main argument that features in the material that the Whips keep handing out to Labour Members—they have done it before every health debate in which I have been involved for the past few months—is that there is a distinction between us when it comes to funding. There is not. We made a total commitment to the same level of funding as the Government’s until 2008. The question concerns the way in which it is spent, how the Department of Health is led and the competence of the Secretary of State, her Ministers and the leadership of the Department of Health.
We heard a measured and thoughtful speech from my hon. Friend the Member for Mid-Sussex (Mr. Soames), who plainly felt that support for the health service was universal but that there was deep disappointment about the absence of productivity gains. He came up with an idea that we should all consider, involving the possibility of an equivalent of a professional training college for public service employees.
My hon. Friend the Member for New Forest, West (Mr. Swayne) was very articulate in demystifying issues relating to the perceptions of many people in constituencies about the needs that can be serviced by the NHS. I am sure that his constituents will be extremely grateful to him for ensuring that the Secretary of State personally heard his advocacy on behalf of those who are suffering serious delays, especially in connection with digital hearing aids, and what he said about the closure of community hospitals on his patch. They will hope that the Secretary of State takes the appropriate action.
My hon. Friend the Member for Guildford (Anne Milton) spoke of her personal experience of the health service. In particular, she stood up for her constituents in Cranleigh. She is finding it very difficult to get any Minister to take account of their health needs.
One Labour Member described her party’s “greatest achievement”, so I shall use the same phrase to describe my hon. Friend the Member for Northampton, South (Mr. Binley), who is our party’s greatest achievement. Displaying his experience of management and gaining
value for money, he invited the Minister to visit Northampton and see for herself what was needed there.
My hon. Friend the Member for Basingstoke (Mrs. Miller) expressed her clear expectation that health care provision should be redirected toward the primary end. However, the health budget has not been adjusted sufficiently to make that deliverable. The Government have resorted to policy rhetoric and failed to provide the mechanism to deliver such provision. My hon. Friends the Members for Croydon, Central (Mr. Pelling) and for Wimbledon (Stephen Hammond) identified on their constituents’ behalf the need for efficient investment in the health service, and to balance finances in order to respond to local need. That point was reflected by my hon. Friend the Member for Hornchurch (James Brokenshire), who discussed costs.
We have to make it clear that the issue in today’s debate, as my hon. Friend the Member for Mid-Sussex said, is the competence of the Secretary of State, not of the hard-working doctors and nurses whom we support, and who are doing their best to deliver health care for our constituents. The shadow Secretary of State made with forensic skill—as skilfully as if he had used a surgeon’s knife—the case for the prosecution concerning the financial competence of the Secretary of State, her Ministers and the Department of Health.
Most people will agree that, sadly, the Secretary of State’s reply was flat-footed and a touch too shrill. If there had been a bucket of sand in the Chamber, Mr. Speaker, you would have believed that, ostrich-like, she had her head buried in it. The problem is not only what she says, but the way in which she says it. Hard-working doctors and nurses—let alone the public at large—are fed up to the back teeth with being talked down to, and with everything being larded with a smile from here to Australia.
Let me recap the howlers that have been committed. The Secretary of State has not listened to NHS staff or to patients. She has consistently meddled and interfered, using centralised, top-down management under the cloak of the word “local”, and ducking the blame as her meddling goes wrong. [Interruption.] Now her Parliamentary Private Secretary, who is from Scotland and has absolutely no relevance to this debate whatever, is trying to intervene from a sedentary position. The Secretary of State has presided over 13,000 job losses so far, with more expected to be announced any day. She has consistently underestimated the deficits, leading directly to real cuts in front-line patient services. She botched a needless reorganisation, and is now returning the organisation of the NHS to a map that applied until 2002.
The Secretary of State has allowed health inequalities to widen. More community hospitals are closing or being cut as we speak. She has had an adverse impact on training and employment throughout the service. Her handling of Herceptin was a fiasco, as my hon. Friend—and neighbour—the Member for North Shropshire (Mr. Paterson) forcefully highlighted. She miscalculated the demand for flu drugs by forgetting about Scotland, Wales and Northern Ireland. She underestimated the new doctors’ and consultants’ contracts, introduced a shambolic dental contract and wasted time and money delaying
the Barts private finance initiative. This year she is underfunding hospitals, and according to the Health Service Journal, the tariff was a “total cock-up”. She has had to cut back, backtrack and apologise, and she has allowed the home oxygen service to collapse. She has made little progress on the targets for methicillin-resistant Staphylococcus aureus, and her NHS information technology programme is behind schedule, under fire from the experts and of uncertain cost—and what a cost.
The Secretary of State failed to get the Chancellor to address the NHS at all in the Budget. She axed the Mental Health Bill and allowed her Ministers to make spending commitments without the money to support them. Public health campaigns—notably the bowel cancer screening programme—have been severely delayed on her watch. Failure is rewarded with the spending of taxpayers’ money in the Department of Health. The Under-Secretary with direct responsibility for public health was promoted. Before the reshuffle there were two Ministers of State and two Under-Secretaries; now there are three Ministers of State and one Under-Secretary. That amounts to a 3 per cent. pay rise within the faction of Ministers—at the very time when doctors and nurses are losing their jobs as a result of their financial mismanagement. Finally, the Secretary of State then tried to blame it all on the Conservatives.
To try to mitigate the financial mismanagement of the NHS, the Secretary of State has sent turnaround teams into the most troubled trusts. The full cost, like so much else, has been kept hidden. There is clearly a pattern, and we must look carefully at it. Of course the NHS deficit is the biggest scandal. It is the legacy that the Secretary of State will leave behind when the Prime Minister next needs to clear the headlines with a reshuffle. Indeed, it is the legacy that the Prime Minister will leave: he will be remembered as the leader of a Labour Government who could not be trusted with the NHS.
The Secretary of State has consistently underestimated the deficits and refused to come clean about the scale of them. If she covers up some failings with the empty cacophony of the restructuring programme, others are hidden by a deafening silence. Our national health service is too important for that. We want it to succeed, and we want it to succeed now. To remedy the financial mismanagement today, we need a turnaround team to go into the Department of Health today.
The Secretary of State survived last week’s Cabinet purges, but turnaround in the Department is needed and her past form shows that she is not the person to deliver it. Bring on the turnaround team to reverse the decline of the NHS over which she has presided. I commend the motion to the House.
9.45 pm
The Minister of State, Department of Health (Andy Burnham): I thank the hon. Member for Eddisbury (Mr. O'Brien) and others for their kind words of welcome. Love identity cards as I do, it is nice to be back on home ground. I do not know whether the hon. Member for Wellingborough (Mr. Bone) had me in mind when he said that he thought that the Government were more interested in spin doctors than real doctors, but I can
assure him that I did a real job once in my life, for the NHS Confederation, and I have served on the Health Committee, so I am not entirely new to health policy.
I pay tribute to my predecessor, my right hon. Friend the Member for Liverpool, Wavertree (Jane Kennedy). She can point to real improvements during her time in office that will be of direct benefit to patients, including the speeding up of the NICE appraisal process and, more recently, the conclusion of deals for the rebuilding of Barts and new hospitals in Birmingham and—closer to home for both of us—St. Helens. I hope to build on her work.
We have had a debate of two halves. We have heard serious contributions, raising legitimate points, from Labour Members, and some thoughtful contributions from Opposition Members, including the hon. Members for Mid-Sussex (Mr. Soames) and for Wyre Forest (Dr. Taylor). I listened carefully to every contribution and as a Minister new to the Department I was encouraged by the picture of progress on the ground that my colleagues mentioned. It was nice, too, that some balance was injected into the debate after the frenzy and overstatement from others. I am under no illusions about the difficult reality in some localities, but balance is important. The NHS is improving, and we have heard about that today.
On the other side of the debate today we have seen the unedifying spectacle of some Opposition Members being determined to talk down the NHS. Today’s debate was all about destabilising the NHS and seeking to create crisis—a word used by several Opposition Members today. Their plan to do so will fail, because it is not backed up by the facts. We had overstatement and bluster from the hon. Member for Eddisbury and the hon. Member for South Cambridgeshire (Mr. Lansley). However, I got the impression that the latter’s heart was not in it. I have a great deal of respect for him and he has a detailed grip of health policy, but his troops were not with him. Nor were they with the hon. Member for Eddisbury just now. That is because the facts do not bear out what they were saying.
At one point, the hon. Member for South Cambridgeshire feigned outrage. He said that patients were waiting nearly six months for an operation. That is a long time and we are determined to reduce it. Despite the problems in some areas, we will bring it down to a maximum of 18 weeks. However, I remind the hon. Gentleman that in March 1997 283,866 people had waited more than six months for an operation. Only 74 people were in that position in January this year, yet Opposition Members still claim that we have made no progress and still they talk of crisis.
I was pleased to hear the balanced contribution from the hon. Member for Northavon (Steve Webb). He mentioned the real improvements we have seen and he rightly reminded the House of the appalling record of the Conservatives in government. He was right, too, to draw attention to the collective amnesia that they have about policies such as the patient’s passport. Only seconds ago, the hon. Member for Eddisbury said that there was no difference between us at the general election and that the Conservatives were committed to the same level of spending. He forgot to say that they were committed to a policy that would have taken millions of pounds out of the national health service. That has been airbrushed from history by the Conservatives and their leader.
They have forgotten about it. We will not forget about it. We know the damage that they have done.
The hon. Member for Northavon gave us a familiar Liberal Democrat refrain and railed against central targets but, if they were the problem, the same pressures would be replicated across the country. We have heard today that the vast majority of NHS organisations are doing well and improving their services, so it too simplistic for the Liberal Democrats to blame everything on central targets. They have brought about real improvements for patients across the country, and it is right that we should continue with them.
I was very pleased to hear the authoritative and knowledgeable contribution from my right hon. Friend the Member for Rother Valley (Mr. Barron), the Chairman of the Health Committee. He injected a note of reason and perspective into this fevered debate, and those who care about the NHS should listen to what he had to say. He painted a picture of improvement across the board in the NHS, and he was right to do so.
As a Minister new to his post, I welcome the inquiry into NHS deficits to which my right hon. Friend the Member for Rother Valley referred. It will be a useful exercise, and I look forward to working with the Select Committee on it. My right hon. Friend is a Yorkshireman and so made some characteristically robust comments about the RCN and its recent conference. I am only two days into my job, so I hope that I will be forgiven for not commenting directly on those remarks, but I am sure that people outside the House will have heard exactly what he said.
I was pleased that the right hon. Member for Charnwood (Mr. Dorrell) contributed to the debate, and am glad that he is back in his place. He reminded us, helpfully, of what the NHS was like in 1996, when he was in control. I was a mere Labour health researcher then, and I remember the right hon. Gentleman well. I felt that he was battling like mad to get more money into the NHS, and that he believed in it when all those around him did not.
However, the right hon. Member for Charnwood was not able to get more money into the NHS. I remember children in the north-west being turned away from paediatric intensive care beds, and the long trolley waits in accident and emergency departments. I also remember the winter hell that recurred—to use the right hon. Gentleman’s own phrase—year on year on year.
Andy Burnham: I remember the postcode prescribing lottery, and GP fundholding.
Mr. Paterson Will the Minister give way?
Mr. Speaker: Order. The Minister is not giving way. The hon. Gentleman is being very noisy—very noisy indeed.
Andy Burnham: The right hon. Member for Charnwood said in this debate that GP fundholding was being reintroduced, but I remind him of the inequitable situation that existed when there were fundholding GPs, and non-fundholding GPs.
| Next Section | Index | Home Page |